{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:21:40Z","timestamp":1777695700919,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T00:00:00Z","timestamp":1603152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007886","name":"Dana-Farber Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007886","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015184","name":"Teenage Cancer Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015184","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006058","name":"St. Baldrick's Foundation","doi-asserted-by":"publisher","award":["#358099"],"award-info":[{"award-number":["#358099"]}],"id":[{"id":"10.13039\/100006058","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2021,1,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adolescents with extracranial metastatic germ cell tumors (GCTs) are often treated with regimens developed for children, but their clinical characteristics more closely resemble those of young adult patients. This study was designed to determine event\u2010free survival (EFS) for adolescents with GCTs and compared them with children and young adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An individual patient database of 11 GCT trials was assembled: 8 conducted by pediatric cooperative groups and 3 conducted by an adult group. Male patients aged 0 to 30 years with metastatic, nonseminomatous, malignant GCTs of the testis, retroperitoneum, or mediastinum who were treated with platinum\u2010based chemotherapy were included. The age groups were categorized as children (0 to &lt;11 years), adolescents (11 to &lt;18 years), and young adults (18 to \u226430 years). The study compared EFS and adjusted for risk group by using Cox proportional hazards analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From a total of 2024 individual records, 593 patients met the inclusion criteria: 90 were children, 109 were adolescents, and 394 were young adults. The 5\u2010year EFS rate was lower for adolescents (72%; 95% confidence interval [CI], 62%\u201079%) than children (90%; 95% CI, 81%\u201095%;\n                      <jats:italic>P<\/jats:italic>\n                      = .003) or young adults (88%; 95% CI, 84%\u201091%;\n                      <jats:italic>P<\/jats:italic>\n                      = .0002). The International Germ Cell Cancer Collaborative Group risk group was associated with EFS in the adolescent age group (\n                      <jats:italic>P<\/jats:italic>\n                      = .0020). After adjustments for risk group, the difference in EFS between adolescents and children remained significant (hazard ratio, 0.30;\n                      <jats:italic>P<\/jats:italic>\n                      = .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EFS for adolescent patients with metastatic GCTs was similar to that for young adults but significantly worse than for that children. This finding highlights the importance of coordinating initiatives across clinical trial organizations to improve outcomes for adolescents and young adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LAY SUMMARY<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Adolescent males with metastatic germ cell tumors (GCTs) are frequently treated with regimens developed for children.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>In this study, a large data set of male patients with metastatic GCTs across different age groups has been built to understand the outcomes of adolescent patients in comparison with children and young adults.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The results suggest that adolescent males with metastatic GCTs have worse results than children and are more similar to young adults with GCTs. Therefore, the treatment of adolescents with GCTs should resemble therapeutic approaches for young adults.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.33273","type":"journal-article","created":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T11:39:47Z","timestamp":1603193987000},"page":"193-202","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Outcomes of adolescent males with extracranial metastatic germ cell tumors: A report from the Malignant Germ Cell Tumor International Consortium"],"prefix":"10.1002","volume":"127","author":[{"given":"Furqan","family":"Shaikh","sequence":"first","affiliation":[{"name":"Hospital for Sick Children, University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Stark","sequence":"additional","affiliation":[{"name":"Institute for Medical Research University of Leeds Leeds United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6382-6833","authenticated-orcid":false,"given":"Adriana","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Hospital for Sick Children, University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ha","family":"Dang","sequence":"additional","affiliation":[{"name":"Children's Oncology Group Monrovia California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caihong","family":"Xia","sequence":"additional","affiliation":[{"name":"Children's Oncology Group Monrovia California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Krailo","sequence":"additional","affiliation":[{"name":"Children's Oncology Group Monrovia California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farzana","family":"Pashankar","sequence":"additional","affiliation":[{"name":"Yale Cancer Center New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Rodriguez\u2010Galindo","sequence":"additional","affiliation":[{"name":"St. Jude Children's Research Hospital Memphis Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas A.","family":"Olson","sequence":"additional","affiliation":[{"name":"Aflac Cancer and Blood Disorders Center Children's Healthcare of Atlanta Emory University Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James C.","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Murray","sequence":"additional","affiliation":[{"name":"Cambridge University Hospitals NHS Foundation Trust Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James F.","family":"Amatruda","sequence":"additional","affiliation":[{"name":"Children's Hospital Los Angeles University of Southern California Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Billmire","sequence":"additional","affiliation":[{"name":"Riley Hospital for Children Indianapolis Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Stoneham","sequence":"additional","affiliation":[{"name":"Children's and Young Persons Cancer Services University College London Hospital Trusts London United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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